International Urology and Nephrology

, Volume 42, Issue 4, pp 1007–1014 | Cite as

Cardiovascular disease in end-stage renal disease: the challenge of assessing and managing cardiac disease in dialysis patients

  • Lisa M. Miller
  • Manish M. Sood
  • Amy R. Sood
  • Martina Reslerova
  • Paul Komenda
  • Claudio Rigatto
  • Joe Bueti
Nephrology – Review

Abstract

Cardiovascular disease (CVD) is the leading cause of mortality in end-stage renal disease (ESRD), approximating a 10- to 20-fold higher risk of death in dialysis patients than in the general population. Despite this, dialysis patients often undergo fewer investigations, receive less invasive procedures, and are prescribed fewer medications compared with age-matched non-ESRD patients. A lack of randomized control trials for evidence-based treatment strategies in this population may explain some of these discrepancies, but there is concern that an attitude of “therapeutic nihilism” may be impacting on the medical care of these patients. In this review, we will explore CVD in the ESRD population. Specifically, we will try to address the following issues in patients with ESRD: (1) mechanisms of CVD, (2) cardiac evaluation and the role of coronary revascularization with percutaneous or coronary artery bypass procedures, and (3) cardiac pharmacotherapy use.

Keywords

Cardiovascular disease Coronary artery disease Dialysis ESRD Cardiac pharmacotherapy 

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Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • Lisa M. Miller
    • 1
  • Manish M. Sood
    • 2
  • Amy R. Sood
    • 3
  • Martina Reslerova
    • 2
  • Paul Komenda
    • 2
  • Claudio Rigatto
    • 2
  • Joe Bueti
    • 1
  1. 1.Department of MedicineHealth Sciences CentreWinnipegCanada
  2. 2.Department of MedicineSt Boniface General HospitalWinnipegCanada
  3. 3.Department of PharmacySt Boniface General HospitalWinnipegCanada

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